Abstract Details

Title Subtypes of Ischemic Stroke in the Young

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 216

Objective

Background BACKGROUND: We examine the frequency of ischemic stroke subtypes among the young, looking for trends over time that might explain this trend.

Design/Methods DESIGN/METHODS: Ischemic strokes were ascertained from the entire Cincinnati metropolitan area during 1993-94, 1999, and 2005 using ICD-9 codes 430-436. Study nurses abstracted all potential cases for physician review, to determine true cases and for ischemic stroke classification by etiologic subtype. To examine age effects, we categorized into ages 20-44 and 45-54. Due to low numbers of events in each of the one-year study periods, we combined events from all 3 periods.

Results RESULTS: No significant subtype trends were discovered across periods, although the number of events under age 55 was prohibitively low in all three periods. When considering all strokes under age 55 and comparing ages 20-44 vs. 45-54, the proportion with small vessel (19 vs. 20%), cardioembolic (10 vs. 12%) and large vessel (9 vs. 14%) were not significantly different. However, in ages 20-44 there were 18% with "other" identified cause and 42% undetermined etiology compared with 6% and 50% respectively in ages 45-54. This led to a significant difference in distribution across age. "Other" causes in the 20-44 group were different (in order of frequency: dissection > hypercoaguable state > cocaine) than in the 45-54 group (post-procedure was double any other cause).

Conclusions CONCLUSIONS: Continuous monitoring will be necessary to see if ischemic stroke subtypes among the young are significantly different over time as these events, although slowly increasing in the past decade, are low frequency even in a large population. The 20-44 year old group has a higher proportion of "other" identified causes, but the 45-54 year old group has a surprising number of post-procedural events.

Authors/Disclosures
Brett M. Kissela, MD, MS, FAAN (University of Cincinnati Hospital) PRESENTER	The institution of Dr. Kissela has received research support from NIH/NINDS. Dr. Kissela has a non-compensated relationship as a Board Member with AHA Regional Board that is relevant to AAN interests or activities.
	No disclosure on file
Kathleen Alwell	No disclosure on file
	No disclosure on file
Daniel Woo, MD, FAAN (University at Buffalo)	The institution of Dr. Woo has received research support from NIH.
Matthew L. Flaherty, MD	Dr. Flaherty has received personal compensation for serving as an employee of Sense Diagnostics, Inc. Dr. Flaherty has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boeringher Engelheim. Dr. Flaherty has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for CSL Behring. Dr. Flaherty has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Alexion. Dr. Flaherty has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for various law firms. Dr. Flaherty has stock in Sense Diagnostics, Inc. The institution of Dr. Flaherty has received research support from NINDS. Dr. Flaherty has received intellectual property interests from a discovery or technology relating to health care.
Pooja Khatri, MD, FAAN (Univ of Cincinnati/Dept of Neuro)	The institution of Dr. Khatri has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lumosa. Dr. Khatri has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bayer. The institution of Dr. Khatri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Diamedica. Dr. Khatri has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Basking Biosciences. Dr. Khatri has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Khatri has received research support from Cerenovus. Dr. Khatri has received publishing royalties from a publication relating to health care.
Opeolu Adeoye	No disclosure on file
Simona Ferioli, MD (UCMC)	Dr. Ferioli has nothing to disclose.
Felipe De Los Rios La Rosa, MD (Miami Neuroscience Institute)	Dr. De Los Rios La Rosa has nothing to disclose.
Dawn O. Kleindorfer, MD, FAAN (University of Michigan Department of Neurology)	Dr. Kleindorfer has nothing to disclose.
	No disclosure on file

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